Myelography in lumbo-sacral plexus injury

Abstract

The myelographic demonstration of dural sacs, or “traumatic meningocoeles”, following brachial plexus injury, is well documented in the English literature. Davies, Sutton and Bligh (1966) described 11 of their own cases, and added these to the 70 cases already described. Abnormal myelographic findings in the lumbosacral region, following nerve root trauma, are, however, very rare. A total of five cases of dural sac formation in this region, following trauma, have been described (Finney and Wulfman, 1960; Goodell, 1966; Alker, Glasauer, Zoll and Schlagenhauff, 1967). We wish to add a further case to those described. The patient, a fit young man of 26 years of age, was admitted to hospital in August, 1968, as an emergency, following a road traffic accident. He had been a rear seat passenger in a car involved in a colllision. He was ejected at the time of impact, but further details of the injury are not known. On admission, he was shocked, and in severe lower abdominal pain. A radiograph of his pelvis demonstrated fractures of the pubic rami on both sides, and an oblique fracture of the right ilium, extending into, and opening the right sacro-iliac joint. The right hip was dislocated (Fig. 1 is a post-reduction film) and there was a tear in the bladder. After reduction of the hip, and surgical suture of the bladder the patient made a good recovery.